Vitapex对年轻恒牙牙髓血运重建术疗效的影响

目的 对比Vitapex和三联抗生素糊剂(TAP)做根管消毒剂在牙髓血运重建术中的临床疗效。 方法 选取2017年1—7月于蚌埠医学院第一附属医院牙体牙髓科就诊的年轻恒牙牙髓坏死或根尖周炎患者40例,按随机数字表法分为实验组(20例)和对照组(20例),2组均行富血小板纤维蛋白(platelet-rich fibrin,PRF)增强的牙髓血运重建术。实验组根管消毒采用Vitapex糊剂,对照组根管消毒采用TAP,并且于术后3个月、6个月、9个月和12个月复诊,观察患牙临床症状和充填物情况,拍摄根尖片观察患牙牙根发育情况并测量患牙根管长度和根管壁厚度。对比2组临床有效率、根管长度、根管壁厚度及牙体变色率。 结果 实验组临床总有效率为90.0%,对照组为85.0%,2组比较差异无统计学意义(P>0.05);实验组治疗前牙根长度为(8.74±0.24)mm,治疗后为(9.12±0.18)mm,对照组治疗前牙根长度为(8.81±0.21)mm,治疗后为(9.21±0.24)mm,2组相比差异无统计学意义(均P>0.05);实验组治疗前根管壁厚度为(2.12±0.32)mm,治疗后为(2.66±0.24)mm,对照组治疗前根管壁厚度为(2.15±0.28)mm,治疗后为(2.71±0.28)mm,2组相比差异无统计学意义(均P>0.05);实验组牙体变色率为25.0%,对照组为100.0%,2组相比差异有统计学意义(P<0.05)。 结论 Vitapex和TAP用于年轻恒牙牙髓血运重建术可以达到同样的临床疗效,但Vitapex作根管消毒剂能有效降低患牙牙体变色率。 

The effect of Vitapex on pulp revascularization in immature permanent teeth

Objective To compare the clinical efficacy of Vitapex and triple antibiotic paste(TAP) as root canal disinfectant in pulp revascularization. Methods From January to July 2017, 40 young patients with pulp necrosis or periapical periodontitis in the Department of Dental Pulp, the First Affiliated Hospital of Bengbu Medical College were randomly divided into experimental group(n=20) and control group(n=20). PRF(platelet-richfibrin) enhanced pulp revascularization was performed in both patients. The root canals were disinfected with Vitapex paste in the experimental group and TAP in the control group. The clinical symptoms and fillings were observed at 3 months, 6 months, 9 months and 12 months after operation. Apical films were taken to observe the root development of the affected teeth and measure the root canal length and root canal wall thickness. The clinical effective rate, root canal length, root canal wall thickness and tooth discoloration rate were compared between the two groups. Results The total clinical effective rate was 90.0% in the experimental group and 85.0% in the control group(P>0.05). The root length of the experimental group was(8.74±0.24) mm before treatment and(9.12±0.18) mm after treatment, while that of the control group was(8.81±0.21) mm and(9.21±0.24) mm respectively, with no significant difference between the two groups(P>0.05). The thickness of root canal wall in the experimental group was(2.12±0.32) mm before treatment and(2.66±0.24) mm after treatment, while that in the control group was(2.15±0.28) mm before treatment and(2.71±0.28) mm after treatment, with no significant difference between the two groups(all P>0.05). The tooth discoloration rate was 25.0% in the experimental group and 100.0% in the control group(P<0.05). Conclusion Vitapex and TAP can achieve the same disinfection effect in pulp revascularization of immature permanent teeth, but Vitapex as root canal disinfectant can effectively reduce the discoloration rate of affected teeth.